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Deactivated NPI 1083746895 Deactivated / Inactive NPI Male Practitioner

Dr. Robert Willard Kettlewell , DDS

Dentist - General Practice • Oceanside, CA

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Robert Kettlewell has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date March 09, 2007
NPI Deactivation Date March 20, 2024
Total Practice Duration ~17 Years of Practice (2007 – 2024)

Professional Overview & Biography Verified Profile Summary

Dr. Robert Kettlewell, DDS was a registered Dentist - General Practice practicing in Oceanside, CA. Throughout an active medical career spanning 17 years, Dr. Kettlewell provided care at the practice location at 3142 VISTA WAY until profile deactivation on 2024-03-20.

Practice Location & Contact Primary Location

Practice Address

3142 Vista Way
#305

Oceanside, CA 920563619

Telephone 7607221416
Fax 7607222230
Associated Practice Facility / Clinic
🏢 Qualitycare Medical Center Facility NPI 1013065234

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Oceanside, CA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 21.7 Yrs
Regional Practice Density
56 Specialists

Practicing in Oceanside, CA (18734 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License CA 40629

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

26 Associated Practitioners
Dr. Dumont Blankenship , PhD

Psychologist - Clinical

NPI 1063506806

Doctor of Philosophy (Ph.D.)

Dr. Ronald Cohen , MD

Family Medicine - Sports Medicine

NPI 1073588786

Doctor of Medicine (M.D.)

Jason Anthony

Social Worker - Clinical

NPI 1134541105
Susanna Beaudieu , LCSW

Social Worker - Clinical

NPI 1184883845

Licensed Clinical Social Worker

Brian Clemente

Psychologist - Clinical

NPI 1205045465
Sarah Cobb

Counselor - Mental Health

NPI 1205142510

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated March 20, 2024

Record deactivated on March 20, 2024

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

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Updated Practice Location July 08, 2007

Registered at 3142 VISTA WAY, #305, OCEANSIDE, CA 920563619 (Tel: 7607221416)

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Updated Business Mailing Address July 08, 2007

Registered at 3142 VISTA WAY, #305, OCEANSIDE, CA 920563619 (Tel: 7607221416)

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Provider Name / Credentials Updated July 08, 2007

Recorded as ROBERT KETTLEWELL, D.D.S.

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Dentist (License #40629 in CA)

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Initial NPI Registration & Enumeration March 09, 2007

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1083746895
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: March 09, 2007
Last Update: July 08, 2007
Deactivation Date: March 20, 2024

Mailing Address

3142 Vista Way, #305

Oceanside, CA 920563619

Phone: 7607221416

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.